Provider Demographics
NPI:1407091325
Name:FISHELMAN, VALERIA CLAIRE (MASTERS)
Entity Type:Individual
Prefix:MRS
First Name:VALERIA
Middle Name:CLAIRE
Last Name:FISHELMAN
Suffix:
Gender:F
Credentials:MASTERS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:53 SEAMAN NECK RD
Mailing Address - Street 2:
Mailing Address - City:DIX HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11746-6819
Mailing Address - Country:US
Mailing Address - Phone:631-996-4143
Mailing Address - Fax:
Practice Address - Street 1:53 SEAMAN NECK RD
Practice Address - Street 2:
Practice Address - City:DIX HILLS
Practice Address - State:NY
Practice Address - Zip Code:11746-6819
Practice Address - Country:US
Practice Address - Phone:631-996-4143
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-05
Last Update Date:2008-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool